Abstract
Purpose :
To report the relationship of obstructive sleep apnea (OSA) and cotton-wool spots (CWS) seen in patients with diabetic retinopathy (DR).
Methods :
A random sample of patients diagnosed with any stage of DR between January 1, 2015 and December 31, 2018 were selected from billing codes. Dilated funduscopic exam (DFE) findings and medical history were confirmed via chart review.
Results :
CWS were present in 14/162 patients without OSA, compared to 12/38 patients with OSA (8.6% vs. 31.6%, p = <0.001). OSA was more common in males (71.1%, p = 0.004) and associated with a higher body mass index (BMI) (28.6±8.1 without OSA vs. 33.3±5.6 with OSA, p = <0.001). When comparing those with and without OSA, respectively, there was no association with age (64.4±12.1 vs. 63.4±11.5 years, p = 0.68); hemoglobin A1C (8.1±2.0 vs. 8.2±1.8, p = 0.35); stage of non-proliferative diabetic retinopathy (NPDR) (39.8% vs. 47.4% in mild NPDR, 27.3% vs. 26.3% in moderate NPDR, and 5.0% vs. 10.5% in severe NPDR, p = 0.29); insulin dependence (57.4% vs. 65.8%, p = 0.34); presence of diabetic macular edema (14.8% vs. 13.2%, p = 0.79); smoking status (70.4% vs. 63.2% in non-smokers, 16.7% vs. 31.6% in prior smokers, and 12.9% vs. 5.2% in active smokers, p = 0.07); or a history of hypertension (91.4% vs. 92.1%, p = 0.88), hyperlipidemia (87.0% vs. 84.2%, p = 0.65), cardiovascular disease (37.0% vs. 47.4%, p = 0.24), or other breathing disorders (9.3% vs. 10.5%, p = 0.81).
Conclusions :
The presence of OSA is associated with CWS in patients with DR, as well as male gender and a higher BMI. Further research is needed to determine the ophthalmologist’s role in the diagnosis and treatment of OSA and its potentially fatal complications.
This is a 2020 ARVO Annual Meeting abstract.